Pathology Guide Book Pdf
Karri Weston
and specimen type is associated with important principles, terminologies, and teaching points that may be relevant to the diagnosis depending on the scenario. For example, the work-up for lung cancer in a small biopsy should focus on preserving tissue to ensure that there is adequate material for molecular testing, whereas tissue preservation is not typically a concern in a larger resection specimen. Another example is frozen section specimens. In these samples, the
diagnostic question is often quite different from those that must be addressed on permanent sections. In this book, we have approached the diagnosis from the point of view of the pathologist looking at a specific specimen type. In keeping with this principle, the chapters are organized by specimen type rather than by disease entity. This approach allows us to provide the reader with practical insights and advice for the work-up and diagnosis of various specimen types. As a consequence, some diagnostic entities appear more than once in the book. We minimize overlap and focus on relevant details that pertain to making and reporting specific diagnoses in the context of a specimen type.
This book is divided into 6 chapters that cover the field of thoracic pathology. In Chapter 1, we discuss small biopsy specimens, focusing on how to diagnose and report cases in which lesional tissue may be minimal, and tissue preservation is an important consideration. In Chapter 2, we provide an approach to reporting thoracic frozen sections. In Chapter 3, we focus on resection specimens and discuss important considerations when reporting lung cancer and other mass-forming lesions. In Chapter 4, we provide a practical approach to non-neoplastic lung diseases that are typically diagnosed in transbronchial or surgical lung biopsies or are seen in the background of resection specimens. In Chapter 5, we discuss the approach to pleural specimens, including mesothelioma and its mimics. Finally, in Chapter 6, we provide tips on how to tackle the immense variety of lesions that pathologists may encounter in mediastinal specimens.
This page is intended to offer further detail on Standard VII of the 2020 Speech-Language Pathology (SLP) Certification Standards; it is not intended to replace the language. The SLP standards must be adhered to in order to be eligible to earn the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP).
The SLP CF is a mentored professional experience that begins after the completion of academic course work and clinical practicum. The goal of the CF is to allow the Clinical Fellow to transition between being a student enrolled in a communication sciences and disorders (CSD) program and being an independent provider of speech-language pathology clinical services.
The purpose of the CF is to integrate and apply the knowledge from academic education and clinical training, evaluate strengths and identify limitations, develop and refine clinical skills consistent with the Scope of Practice in Speech-Language Pathology, and advance the Clinical Fellow from needing constant supervision to being an independent practitioner.
The role of mentor is to (a) oversee the duration of the CF experience; (b) verify completion of required hours, segments, and activities; (c) provide structured feedback on a regular basis; and (d) sign off on independence of skills by the end of the CF.
As a Clinical Fellow, you must work at least 36 weeks and 1,260 hours to meet the ASHA CF experience requirement. In addition, you must work at least 5 hours per week to be able to count the hours/week toward the minimum requirement. Travel, lunch, vacations or holidays, leaves of absence, and other forms of paid or unpaid time off cannot be counted toward your number of hours worked per week. The CF experience should be divided into 3 segments with each segment representing one-third of the total. Each third should include the observations and supervisory activities that are required by the CF mentor.
A minimum of 80% of the CF experience must be spent in direct clinical contact related to the management of disorders that fit within the ASHA Scope of Practice in Speech-Language Pathology. Examples of direct clinical contact include the following:
If you have multiple CF mentors and/or segments, all CF experiences/segments related to your certification application must be completed within 48 months of the date of your first CF experience/segment.
The ASHA CF experience may be started only after all academic coursework and supervised clinical practicum have been completed and verified by your graduate program director, as outlined in the ASHA SLP Certification Standards, including all prerequisite coursework (Standard IV-A), core coursework (Standard IV-C), and supervised clinical practicum (Standard V). Professional experiences prior to the completion of all academic coursework and practicum cannot be used or applied toward your CF experience.
Before beginning the CF, it is important that a Clinical Fellow ensures that their CF mentor meets all of the required qualifications listed in Standard VII-B: In order to count the hours that you have earned, mentoring SLPs must
It is a Clinical Fellow's responsibility to verify their CF mentor's status to ensure their mentor's certification remains current throughout the duration of the CF experience. Periodic verification of your mentor's status is a good practice to follow, such as
In order to provide an accurate rating of a Clinical Fellow's independence with each skill on the CFSI, each mentor must complete a minimum of 6 hours of on-site and in-person direct and 6 hours indirect observation during each segment (or part-segment) that you serve as their CF mentor. This equates to 18 hours of direct and 18 hours of indirect supervision during the full CF experience. You may provide more supervision if your local or state policies require more, or if you feel that your Clinical Fellow would benefit from more supervision.
During each segment of the CF experience, each CF mentor must provide a minimum of 6 hours of direct observation of the Clinical Fellow as they provide evaluation or treatment services to the patient/client. Remember, a segment is equal to one third of the CF experience. At least 3 direct observation hours per segment and per mentor must occur in person.
Each mentor must also provide, per segment, 6 hours of indirect observation, which typically include reviewing diagnostic reports/treatment records/plans of treatment, monitoring the Clinical Fellow's participation in case conferences or professional meetings, and/or evaluating the Clinical Fellow's work by consulting with colleagues or clients and their families. The CF mentor and the Clinical Fellow must coordinate the observation schedule to ensure that all skills are observed and evaluated during each segment of the CF experience. It is expected that the observations are spread over the duration of the CF experience, with no more than 6 total observation hours completed in 1 day. You may use this template for tracking supervisory activities [PDF].
For the purposes of ASHA certification, Clinical Fellows may work in more than one location and they may have more than one CF mentor. If the Clinical Fellow has more than one CF mentor, each CF mentor must complete the required supervisory activities for the weeks and hours to be counted toward the completed CF unless the CF mentors collaborate to provide a robust CF experience. In these instances, both mentors must share the same employer, and one CF mentor becomes the primary mentor and completes the CF report on the Clinical Fellow's online certification application.
If a Clinical Fellow changes settings (e.g., works full time in a school and works PRN at a skilled nursing facility), they must have the CF mentor evaluate all skills in each setting during each segment. In this example, the Clinical Fellow may choose to have two CF mentors; one at the school and one at the skilled nursing facility.
Clinical Fellow Changes Settings/Employers Between Segments
In order for hours/experiences to be counted, the minimum of 6 hours of direct and 6 hours of indirect supervision per segment (or part-segment) must be completed by each CF mentor. If a Clinical Fellow completes a partial segment that did not include at least 6 hours of direct and 6 hours of indirect supervision from their CF mentor prior to changing settings/employers, the new CF mentor cannot make up any supervisory hours that were deficient from the previous setting.
If the CF mentor anticipates at any time during the CF that the Clinical Fellow will fail to meet requirements, the mentor must counsel the Clinical Fellow (both verbally and in writing) and maintain written records of all contacts and conferences that had been conducted during the experience. A negative recommendation for segments 1 or 2 will not impact certification eligibility unless there is evidence that the Clinical Fellow may have engaged in unethical practice. If the CF experience is terminated at any time before completion of the CF, or if the CF mentor does not recommend approval, the CF mentor must complete the online CF Mentor Verification page and provide justification for the negative recommendation.
CF experiences with negative recommendations related to unethical practice may not be applied toward the total number of hours/weeks required to complete the CF unless reviewed and approved by the CFCC.
Within 30 days of making the negative recommendation, the CF mentor must submit to the CFCC a letter of explanation with supporting documentation. This information must be shared with the Clinical Fellow. Following a negative recommendation, the Clinical Fellow may complete an entirely new CF, one or more segments of the CF, and/or request an appeal by the CFCC.
Applicants who have applied for ASHA certification through the online application process must login to their ASHA account and enter the CF experience details. CF mentors will then receive an e-mail requesting that they verify and complete the documentation on their CF mentor portals within their ASHA account. Verification must be completed within 90 days of the end of the CF experience.
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